In the Population Health World, Put Cutting-Edge Care Coordination in Your Toolkit

Date: July 7, 2021

Time: 2:00 PM-3:00 PM EDT


This webinar will address the role and value of care coordination in a population health world (including a brief history/definition of population health), where PALTC practitioners follow their patients throughout the care continuum. It will walk participants through the creation and coordination of a care coordination team, including the skills, knowledge, and experience necessary for the team to be effective; what communication/information/data each team member will need; how to share roles/expectations and track outcomes/progress; how to document, track, and analyze data to identify successes as well as opportunities for improvement; and how to work with patients and families on advance care planning. A case study will let participants use what they’ve learned, as well as their own experiences, to take a patient through the continuum, and problem solve as part of a population health team.

Learning Objectives:

  • Develop an effective population health-focused care coordination team.
  • Use care coordination to collect data (such as medications and treatment goals) from all the specialists the patient sees, consolidate, and establish a single unified care plan that follows the patient throughout the PALTC care continuum.
  • Identify, establish relationships, and communicate with social and other agencies in the community and the state to support patients' social, financial, and other supports and services.
  • Implement a care coordination team that functions effectively during a crisis such as a pandemic and is flexible enough to meet the special needs created for such a situation.

Speakers: Bader Almoshelli,MD; Hamza Osto, MD

Bader Almoshelli, MD, is a founding partner and CEO of Illinois-based Community Physicians. He is also medical director at Troy Medicare, a Medicare Advantage plan powered by pharmacists and physicians to bring local care to communities nationwide. He has expertise in coding, particularly related to the Patient Driven Payment Model. He is a graduate of Loyola University Chicago Stritch School of Medicine.

Hamza Osto, MD, works with health care facilities and ACOs around the country to provide free or low-cost solutions for patient care. He also has extensive experience in technology-enabled care. His company, Frontizo, specializes in chronic care coordination and transitional care management. He is a board member of the Area Agency on Aging in Michigan, and he is a graduate of the Xavier Medical School.

Credit Information:

  • 1.0 CME
  • 1.0 CMD Management
  • 1.0 MOC

Credit Statements:

AMDA - The Society for Post-Acute and Long-Term Care Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDA – The Society for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This live activity has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 1.0 management hours toward certification or recertification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM. Each physician should claim only those hours of credit actually spent on the activity.

Maintenance of Certification (MOC):
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 Medical Knowledge MOC points and patient safety MOC credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Disclosure Information:

The Society requires the disclosure of all speaker/faculty/planner’s relevant financial relationships; presence of off-label use of a device or medication; and discussion of any experimental, new or evolving topic prior to each accredited education activity.

If the learner perceives any bias toward a commercial product or service, advocation of unscientific approaches to diagnosis or therapy, or recommendation, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients please report this to the Society’s staff.

All relationships have been identified, mitigated, and resolved.

The speakers have no financial relationships to disclose.

The following AMDA Online Education Committee members have financial relationships to report: Robert Zorowitz, MD, MBA, CMD – United Health Group: Stock Shareholder; all others have no relationships to disclose.

AMDA staff have no financial relationships to disclose.